Prevalence of hematuria in urothelial neoplasia

Voided urine specimens from 82 cases of histologically verified urothelial neoplasia (transitional cell carcinoma grades I, II, III, and carcinoma in situ [CIS] ) were evaluated for the presence of gross and microhematuria (MH). Microhematuria was assessed macroscopically with the reagent-strip blood test and evaluated microscopically with enumeration of erythrocytes using a standardized semiquantitative Papanicolaou-stained urine sediment examination. The authors' retrospective study indicated that gross hematuria rarely was present in urothelial neoplasia, however, occult blood (greater than 5 RBC/HPF) was present in four out of five cases when one sample was examined. In some cases there was an overlap between the number of erythrocytes excreted by control population and those with urothelial neoplasms. Urine sediment examination was more sensitive than reagent-strip testing for MH in patients with urothelial neoplasia.